Medical Advances Brighten Outlook For NJ's Cancer Patients

New Jersey Business, Apr 01, 2006 by Brice, Ann Roberts

The number of cancer deaths in the U.S. has been declining for some 15 years, but only lately has the rate of decline begun to outpace U.S. population growth. Medical experts speculate that increased longevity of cancer patients is due to people smoking less and to their being diagnosed and treated earlier.

Specifically, the number of cancer deaths dropped slightly to 556,902 in 2003, down 369 from the 557,271 deaths the prior year, according to the review of death certificates released in February by the Center for Disease Control & Prevention's (CDC) National Center for Health Statistics (NCHS). This was the first decrease since 1930, when it began to compile such data.

Several medical professionals polled by New Jersey Business agree that it is hard to know precisely what accounts for the death rate drop although they note that it's been "a long time coming." The oncologists credit earlier technologies that have allowed them to diagnose sooner and to intervene, resulting in greater potential for cure.

In commenting on the trend reversal, the medical professionals add that they are "optimistic," even "excited," about the hope that the future holds for cancer patients in terms of new approaches and treatments and advances that contribute to quality of life and patient survival.

Due to scientific advances made mainly in the past five years, the New Jersey experts believe that cancer, although not likely to be "cured" in our lifetime, will be able to be increasingly "managed" like other chronic diseases. The physicians and nurses - some in oncology for close to three decades, agree that more has occurred in the field during the past few years than in the previous 30.

Multi - disciplinary Approach

"There was a long period when the land was fallow and not very productive, but this is no longer true," says Dr. Allen Chinitz, an oncologist and director of Valley Hospital's Cancer Committee, which directs its cancer program. He calls attention to the dramatic changes in therapies, in approaches to patient care and in symptoms management and quality of life.

Community hospitals like Valley Hospital in Ridgewood are aspiring to a "multi-disciplinary" approach in treating patients following the model of New York-based Memorial Sloan-Kettering Cancer Center (which has New Jersey locations in Denville and Dover, along with a Basking Ridge center due to open in September) and some major teaching hospitals. Such outpatient clinics or centers are a form of "one-stop shopping" for patients and replace the "fragmentation of services" all too frequently seen before.

To realize its goals, in 2002 Valley opened its regional comprehensive cancer center, the Daniel and Gloria Blumenthal Cancer Center, located in Paramus and a few miles from its main campus. Last year, about 1,400 new cases were evaluated and began treatment at this facility. The hospital's oncology unit is used for inpatients; out-patient treatment is done at the Center.

Physicians at the Center are building a system where patients will see many practitioners at the outset of their treatment - medical oncologists, radiation therapists, surgical specialists and experts in particular cancer sites - instead of the traditional sequential approach.

Valley has a second commitment - to conduct more clinical trials at the center, particularly with molecular medicine and targeted therapies. "That (targeted drugs) is really where the excitement in the field lies," comments Chinitz.

"The area of targeted therapies is yielding a virtual explosion of drugs," including those that exploit the mechanisms of angiogenesis, where you literally starve the tumor by depriving it of its blood supply, says Chinitz.

The first of its kind to be approved by the FDA is the monoclonal antibody, Avastin (bevacizumab), for treatment of colon cancer. The drug was developed by Genentech, in which Nutley-based Roche is the majority stockholder. Avastin is also being studied for use in treating breast, lung and other cancers.

The so-called "targeted" therapies consist of specific chemicals, compounds and molecules that are targeted to sites on cancer cells, which themselves are getting to be better understood, says Chinitz. Hormone receptors on breast cancer cells have opened treatment to hormonal preparations like Tamoxifen, available as a generic, or the newer aromatase inhibitors such as AstraZeneca's Arimidex (anastrozole).

Besides hormonal therapies, the new targeted therapies include Genentech's Herceptin (trastuzumab) for treating breast cancer, and others therapies like Genentech and IDEC's Rituxan (rituximab) for non-Hodgkin's lymphoma, Genentech and OSI's Tarceva (erlotinib) for pancreatic cancer, and Imclone's Erbitux (cetuximab) for colon, head and neck cancer.

Sometimes the targeted drugs are used by themselves and in other instances, in combination with chemotherapy, and also in combination with one another, notes Chinitz.

Care Near Home Another Bergen County hospital, the Regional Cancer Center at Holy Name in Teaneck, offers quality care to patients close to home, keeping them from crossing the river to New York City. Some patients prefer to forego a large academic medical center for the intimacy and convenience of a smaller setting, while maintaining confidence in the quality of care, the hospital notes.